Symposium

The Singapore Early Psychosis Intervention Programme (EPIP) was established up in April 2001 offering integrated, multi-disciplinary care to young people with first-episode psychosis. Over the years, our focus has moved from remission to recovery and the key linchpin in enabling this transformation has been our case management service. Case managers conduct bio-psycho-social assessments and provide interventions for our clients for a period of 3 years.

Objective: Emotion recognition (ER) is found to be impaired in chronic schizophrenia, first-episode psychosis (FEP) and individuals at ultra-high risk (UHR) for developing a psychotic disorder, suggesting it may be a vulnerability marker. The aim of this presentation is to examine the evidence for ER as an endophenotype for psychotic disorder by investigating: 1) the specific ER impairments in UHR; 2) ER in unaffected first-degree relatives (FDR) of people with FEP; and 3) ER as a predictor of transition to a psychotic disorder in UHR.

Background: Recently, neurocognitive and social cognitive dysfunctions are frequently reported in individuals at clinical high risk (CHR) for psychosis. However, longitudinal research is needed to confirm whether this is a specific marker for the transit to psychosis and remit from initial high risk state.Method: Seventy-five CHR subjects and 61 healthy controls were recruited, and their neurocognitive and theory of mind task performances were assessed.

Social problems prospectively predict the onset of psychosis and the severity of schizophrenia, suggesting that social problems could be an effective target for prevention and treatment, yet the underlying causes are unknown. Successful social relationships require the ability to understand and empathize with others. Simulation facilitates this ability and involves using ones own experience to understand what the other person is feeling.

BackgroundPeople with an ultra high risk (UHR) for psychosis display deficits in various cognitive domains, including social cognition. This meta-analysis summarizes empirical studies on social cognition in the UHR phase in four domains: emotion perception (recognition of facial affect and prosody), Theory of Mind, social perception and attribution style.MethodsEligible studies were identiﬁed through computerized searches of the Medline (PubMed) and PsycINFO bibliographic databases during 1995 to 2014.

Background: The onset of psychosis occurs when people are engaging in important developmental tasks. One of these is vocational development: finishing secondary school; moving to further study or training; and entering the workforce. Individual Placement and Support (IPS) is an effective intervention to address employment and education in young people with psychosis. However, a number of challenges exist that need still to be addressed. These include factors related to the client, and external factors such as a changing world of work in which job security is diminishing.

Background: Supported Employment (SE) has been shown in numerous controlled trials to be the most effective intervention for helping patients return to paid employment but is poorly implemented in practice because of scepticism and ambivalence of clinical staff.

Background: Individual Placement and Support (IPS) is an evidence based employment intervention. A number of studies have now shown the effectiveness of IPS in returning young people with first episode psychosis (FEP) to employment and education. However, there has been less focus on the educational outcomes, and there is little known about the systematic national implementation of IPS. This presentation will address both of these elements.Method: Two RCTs of IPS and an uncontrolled study of IPS for education specifically have been conducted.

The RAISE-ETP program was designed to develop and evaluate an integrated treatment for first episode psychosis (NAVIGATE) in real world, non-academic, community treatment sites in the USA We selected 34 clinics, located in 21 states, and randomized the sites (clusters), rather than individuals, to either implement NAVIGATE or to provide customary Community Care for subjects in the study. Cluster randomization insured that clinicians at Community Care sites were not exposed to NAVIGATE in order to avoid spillover/contamination effects.